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Binding of (3H)benzo(a)pyrene to DNA in cultured human bronchus.

The studies reported here demonstrate some of the factors affecting the binding of benzo(a)pyrene (BP) to macromolecules in cultured human bronchial mucosa. Bronchial specimens were obtained at either surgy or "immediate" autopsy from patients with and without lung cancer. Grossly normal-appearing pieces of bronchus were cultured in a chemically defined medium, i.e., CMRL 1066 medium containing 1 mug insulin per ml, 0.1 mug beta-retinyl acetate per ml,, 0.1 mug hydrocortisone hemisuccinate per ml, 2 mM L-glutamine, 100 units penicillin G per ml, and 100 mug streptomycin per ml. After 7 days, explant cultures were exposed to [3H]BP, usually for 24 hr, and then binding to total cellular macromolecules was studied by autoradiography, and binding to DNA was measured following isolation of DNA from bronchial mucosal cells. The extent of binding of [3H]BP was dependent on dose of BP, length of exposure to [3H]BP, and temperature. By autoradiography, bronchial epithelial cells bound more [3H]BP than stromal fibroblasts. Both 7,8-benzoflavone and butylated hydroxytoluene appeared to reduce the level of [3H]BP bound to DNA, while nicotine apparently did not alter the level of binding. These studies demonstrate that the bronchial mucosa, an important human cancer target tissue, has the capability to form metabolites of BP which bind to macromolecules including DNA. In addition, 7,8-benzoflavone and butylated hydroxytoluene, both known to alter the microsomal metabolism of BP, reduce the level of [3H]BP bound to DNA.

Benzopyrenes↗

Radiographically occult right main bronchus intubation with a fastrach laryngeal mask airway endotracheal tube.

We report a case in which the distal 3 cm of an LMA-Fastrach laryngeal mask airway (LMA) endotracheal tube (ETT) was radiographically invisible. After the LMA intubation, left lung atelectasis developed. The radiopaque wire coil built into the ETT was mistakenly believed to mark the end of the ETT, so the radiograph made it appear that the end of the ETT was 2 cm above the main carina. In fact, this type of ETT extends 3 cm beyond the end of the wire coil, and the final 3 cm of the ETT can be difficult or impossible to see on a radiograph. Bronchoscopy revealed that the end of the ETT was in the bronchus intermedius. In this case, even in retrospect, the true end of the ETT could not be seen on the radiograph. Clinicians should be aware that the final 3 cm of the LMA-Fastrach ETT can be radiographically invisible. We believe the manufacturer should redesign this ETT to include better radiopaque markers all the way to the end of the ETT.

Adult↗

[Lobectomy extended to the main bronchus in the treatment of bronchial cancer (seventy-three cases)].

Sleeve allow excision of bronchial carcinoma in patients not able to functionally tolerate pneumonectomy. Our series consists of 73 patients operated over the last thirty years. Implantation of the bronchus was treated either by wedge resection or by complete resection followed by reimplantation. This procedure was performed for respiratory functional reasons in 39 cases (53%), on principle in 27 cases (37%) and in palliative indications in 7 cases (10%). The high perioperative mortality (6.8%) and morbidity (20%) were related to bronchovascular complications which were eliminated over the last decade. Local recurrences (23%) were more frequent than following conventional resections. On the other hand, the survival, 80% at one year, 62% at 2 years, 54% at 3 years and 39% at 5 years, related more to metastatic dissemination than to local recurrence, was comparable to that of the control group of pneumonectomised patients. This procedure gave identical results in terms of survival, but should be reserved for patients with respiratory failure due to the increased risk of local recurrence.

Adult↗

[Experience in repairing fistula of bronchus by Eleosor's method].

The repairing treatment of 10 cases of the fistula of bronchus stump by us/ng Eleosor method was reported in this article. All the 10 cases were cured once and no one died of operation. The author have introduced the way of operation and compared it with the other methods of treating such a disease at present. This operation method have the characteristics of collapsing the thorax on the troubled side thoroughly, filling the fistula with large fresh muscles which have very good blood circulation and suturing the wound by the nearest sleeve way etc. The curative effects of such treatment is superior to other way of operation.

Adult↗

[Immunohistochemical analysis of CA19-9, SLX, and CA125 in adenoid cystic carcinoma of trachea and bronchus].

We examined the usefulness of 3 carbohydrate antigens, CA19-9, CA125, and SLX, as tumor markers in adenoid cystic carcinoma of the trachea and bronchus, immunohistochemically and clinically. CA19-9 and SLX were detected immunohistochemically in normal tracheal and bronchial glands, but CA125 was not detected. Bronchial secretions obtained from 7 patients without cancer contained high levels of these 3 carbohydrate antigens. There was positive immunohistochemical staining for CA19-9, CA125, and SLX in 5 of 9, 1 of 9, and 3 of 8 patients with tracheal or bronchial adenoid cystic carcinoma, respectively. In a case of bronchial adenoid cystic carcinoma in whom pretreatment serum CA19-9 showed a very high level, this marker changed in parallel with the clinical course. These results suggest the possibility that CA19-9 and SLX could be used as useful markers in patients with tracheal and bronchial adenoid cystic carcinoma.

Antigens, Tumor-Associated, Carbohydrate↗

p53 and chromosome 3 abnormalities, characteristic of malignant lung tumours, are detectable in preinvasive lesions of the bronchus.

Bronchial epithelial dysplasia is believed to precede invasive squamous cell carcinoma of the lung. Six paired dysplasia and tumour samples were distinguished histologically in sections of formalin-fixed paraffin-embedded lung tissue from patients with lung cancer. Additionally, samples of dysplastic bronchial epithelium were obtained from patients without lung tumours. Microdissection of the unstained sections provided dysplastic and tumour samples from which DNA was prepared for comparison with the patients' constitutional genotype, using polymerase chain reaction-based restriction fragment length polymorphism analysis. All six samples of tumour and the paired adjacent samples of bronchial dysplasia showed loss of heterozygosity (LOH) at loci on the short arm of chromosome 3. Five of the six cases showed involvement of the p53 gene as assessed by LOH at the AccII site within the gene, and by immunoreactivity to CM-1, an antibody which recognizes the mutated form of the p53 protein in paraffin-embedded material. Of the dysplastic samples, obtained from patients without invasive tumours, all three showed LOH at 3p; one sample showed LOH at the AccII polymorphic locus within the p53 gene, and another sample, uninformative at this locus, stained positively with this antibody. These results indicate that somatic genetic changes are present in preinvasive lesions in the bronchus.

Base Sequence↗

Tracheal bronchus associated with bronchiectasis. Case report.

The authors describe a case of ectopic tracheal bronchus (TB) in a 42 years old female. This TB presented bronchiectasis determining various episodes of inflammation in the pulmonary district depending on it. The result of those episodes was atelectasis and fibrotic alterations of the superior right lobe. The mean diagnostic procedure was bronchography. Surgical treatment was performed (superior right lobectomy) with a good result controlled in a 5 year follow-up.

Adult↗

Platelet-activating factor-induced contraction of human isolated bronchus.

In recent years, platelet-activating factor (PAF) has been strongly implicated as a mediator involved in asthma. In non-asthmatic subjects, aerosolized PAF has been shown to cause bronchoconstriction. The mechanism of this in vivo effect is unknown. We have previously shown that PAF causes a contraction of human isolated bronchus that varies in magnitude between patients, and within tissues from the same patient. To examine the possibility that this variability in contraction was secondary to PAF-induced release of mediators from inflammatory or epithelial cells within the tissue, we examined the relationship between contractile responses to PAF and the presence of inflammatory or epithelial cells. We studied eight tissues from five patients. Of the eight tissues, four contracted, whilst four failed to contract, to PAF (7 x 10(-7) M). After the contractile response to PAF had been assessed by observing changes in isometric tone in vitro, bronchial rings were examined histologically to enable the quantification of inflammatory cell numbers and intact epithelium. No significant correlation was observed between the magnitude of contractions and numbers of eosinophils, neutrophils, lymphocytes, plasma cells, total cells or percentage intact epithelium. We conclude that it is unlikely that the variability in response to PAF in human isolated airways is related to the variability in inflammatory cell numbers or to the presence of epithelium. Thus, the contraction induced by PAF is probably not mediated via the release of a secondary mediator from the particular cells examined in this study.

Bronchi↗

Diagnosis of complete mainstem bronchus avulsion by 3-dimensional spiral CT scan of the chest.

Tracheobronchial injury (TBI) after blunt trauma of the chest is a rare life-threatening entity that can be successfully managed by surgery if there is an early diagnosis. A 18-year-old man was injured in a motocycle accident. Three consecutive flexible bronchoscopies risulted negative for tracheo-bronchial lesions. Then, the patient was submitted to a spiral CT-scan of the chest with 3-dimensional reconstruction of the tracheobronchial tree that showed a rupture of the right main bronchus from the trachea. The lesion was successfully treated by surgery. Bronchoscopic findings in TBI may be unclear also for an experienced thoracic surgeon.

Accidents, Traffic↗

Ultrastructural and immunohistochemical studies on the ontogenic development of bronchus-associated lymphoid tissue (BALT) in the rat: special reference to follicular dendritic cells.

The ontogenic development of lymphoid and non-lymphoid cells in bronchus-associated lymphoid tissue (BALT) of the rat was studied ultrastructurally and immunohistochemically. In the late foetal period, only the alveolar macrophages showed a weak positivity for leucocyte common antigen, but no immune region associated (Ia) antigen was detected by monoclonal antibody, MAS 043. Mast cells were present. At 6 days of age, Ia-positive cells were observed in the alveolar wall and peribronchial interstitial tissue, and ultrastructurally there was an aggregation of the fibroblastoid mesenchymal cells. By 10 days of age, the aggregation of lymphoid cells together with S-100-positive reticulum cells had formed a BALT-like periarterial lymphoid sheath. In the adult animals, an obvious B-cell area was present in the central part and subepithelium of BALT, whilst in this area, S-100-positive, strongly Ia-positive cells with a dendritic form were observed. These dendritic cells appeared to be identical to the follicular dendritic cells (FDC) seen in the secondary follicles of lymphoid organs. Those cells may be derived from the fibroblastic reticulum cells, and may function to present antigen to lymphocytes.

Animals↗

Right aortic arch causing left bronchus obstruction.

A case is reported of a right aortic arch vascular ring composed of a right aortic arch with mirror image branches and a retroesophageal left aortic diverticulum with a left ductus arteriosus that appeared as a possible foreign body aspiration in an infant. This vascular ring caused partial occlusion of the left main bronchus with air trapping. A discussion of right aortic arch vascular rings and vascular anomalies that have caused unilateral lung hyperinflation is included in this report.

Journal Article↗

[Tracheal bronchus which is characterized with persistent cough].

A 57-year-old man admitted to department of pulmonary medicine with a history of persistent cough. Computed tomography showed there was a right tracheal bronchus originated from 1/3 distal region of trachea. We reported this case because of the rarity of pulmonary anomaly.

Abnormalities, Multiple↗

[Hypoplasia of trachea with tracheal bronchus as a complication of surgical correction of tetralogy of Fallot].

A 10 months old infant underwent repair of tetralogy of Fallot with hypoplastic annulus of the pulmonary valve, diminutive pulmonary arteries, right aortic arch and left superior vena cava. The right ventricular outflow tract was reconstructed using a monocusp patch. The postoperative course was unfavourably influenced by respiratory complications due to tracheal bronchus and hypoplasia of trachea, which were not diagnosed preoperatively. Extreme emphysema of the right upper and middle lobes compromised haemodynamics. Repeated reoperations were required. The upper and the middle lobes of the right lung had to be resected, the hypoplastic trachea reconstructed with a pericardial patch and pulmonary homograft inserted. One year later, homograft had to be replaced and tricuspid annuloplasty performed for pulmonary and tricuspid regurgitation and right ventricular dilatation as a consequence of increased pulmonary artery pressure. Three years after the original surgery the patient remains in good clinical condition.

Humans↗

[A suspected case of perforation of a lymph node into the bronchus during the treatment of adult hilar lymph node tuberculosis].

A 27-year old patient was diagnosed as having post-primary hilar lymph node tuberculosis. First being admitted to the hospital with a high fever, a chest x-ray examination revealed a swelling of the left hilar lymph nodes and a sputum smear tested positive for acid-fast bacilli. Neither regular clinical examination or investigation had reported abnormality. The acid-fast bacilli was successfully treated through treatment using INH RFP SM. However, after two months, swelling was observed in the right para-tracheal lymph nodes, Further, a bronchoscopic examination revealed polyp-like tumors at the left upper and lower bifurcation. The swelling of the para-tracheal lymph nodes was considerably reduced and the tumors non-existent after five months. These lymph node reactions could have likely been a part of the so called early exacerbation. The polyp-like tumors were not found during the bronchoscopy performed during admission to the hospital. It is therefore suspected that the cause was perforation of the hilar lymph node into the bronchus.

Adult↗

[Clinical prognosis of principal bronchus stump failure in lung cancer patients].

Use of vascular flap to cover the principal bronchus stump for prevention of bronchopleural fistula is generally known. To provide objective evidence on relevant indications, a multivariate analysis of 14 potential risk factors of suture failure was undertaken. Right-side surgery and preoperative irradiation appeared to be significant (p<0,05) factors of high risk (over 25%) for stump suture failure. Either risk factor may be regarded as indication for making preventive plastic cover.

Female↗

[Application of an expandable metallic Z-type stent for stenosis of the left main bronchus following tuberculosis--a case report].

A 32-year-old man had been suffering from dyspnea on exertion and stridor, which were due to stenosis of the left main bronchus as a complication of bronchial tuberculosis. A three-connection stent, 1.2 cm in diameter and 4.5 cm in length was placed at the site of the bronchial stenosis. Dyspnea disappeared 2 days after the procedure, and the pulmonary function 3 weeks later showed considerable improvements in %FVC, FEV1 and MMF.

Adult↗

Dopamine nerve fibres and related receptors in bronchus-associated lymphoid tissue (BALT).

Age-related changes of the dopamine nerve fibres of bronchus associated lymphoid tissue (BALT) were investigated in male Wistar rats of 3 months (young), and 24 months (old/aged). Dopamine histofluorescence techniques have been used, associated with image analysis for the detection of dopamine nerve fibres. In young rats, white, fluorescent nerve fibres supply BALT. This tissue is innervated by a delicate network of nerve fibres rich in varicosities. In old rats these fluorescent nerve fibres are strongly reduced. Moreover, dopamine D1a and D1b receptors were stained using fluorescent monoclonal antibodies. The BALT of young rats possesses a higher number of D1a and D1b receptors, while, in the old rats, these receptors are strongly reduced. The possible significance of reduced dopamine neurotransmission in BALT of aged rats is discussed.

Aging↗

[Surgical managements of the compression of trachea and/or bronchus associated with congenital cardiovascular anomalies].

From 1987 through 1990, 17 cases with tracheal and/or bronchial compression due to congenital cardiovascular malformations were experienced at our institutes. Respirator was required preoperatively in 10 patients (59%) due to severe respiratory symptoms by airway compression and narrowing. In all cases, bronchoscopy was carried out pre- or intra-operatively for the precise diagnosis and for the decision of operative procedures. Postoperatively 12 cases were successfully extubated and remained free of respiratory distress. We investigated the relationships among pre- and post-operative pressure ratio, preoperative flow ratio, requirement of preoperative respirator and indication for plication and suspension of pulmonary artery in the group of the patients, who had airway compression by the dilated pulmonary artery due to large left to right shunt. As a result of this investigation, these factors have no significant correlation. The severity of associated tracheomalacia might be a most susceptible cause, which required the preoperative managements with respirator and the surgical interventions to the dilated pulmonary artery. Infant with patent ductus arteriosus (PDA) could be surgically treated by the division of PDA through left lateral thoracotomy. If the left main bronchus shows complete obstruction after division of PDA, the additional surgical intervention like suspension of aortic arch is needed. Two cases were lost with reoperation and these suggested not only the priority of simultaneous repair of trachea and cardiovascular anomaly, but the necessity of minor intervention against adhesion (insertion of Gore-Tex sheet between suspended pulmonary artery and sternum) in the first-step palliative operation.(ABSTRACT TRUNCATED AT 250 WORDS)

Aorta↗